NEET-PG 2015 Practice Questions

Q: Which muscle of the arm has additional supinator action?

Biceps. ***Biceps*** - The **biceps brachii** powerfully supinates the forearm, especially when the elbow is flexed, due to its distal attachment on the **radial tuberosity**. - Its two heads originate from the scapula, contributing to both **flexion** at the elbow and supination. *Brachialis* - The **brachialis muscle** is the primary and most powerful flexor of the elbow joint. - It inserts onto the **ulna** and does not have any rotational or supinator action. *Coracobrachialis* - The **coracobrachialis** muscle primarily functions in adduction and flexion of the arm at the shoulder joint. - It has no attachments that allow for supination of the forearm. *Triceps* - The **triceps brachii** is the sole extensor of the elbow joint, located on the posterior aspect of the arm. - It is an antagonist to the biceps and has no supinator action.

Q: Which of the following muscles is not attached to the medial border of the scapula?

Teres major. ***Teres major*** - The **teres major** muscle originates from the **inferior angle and lower part of the lateral border** of the scapula, NOT the medial border. - It inserts into the medial lip of the intertubercular groove of the humerus. - This is the correct answer as it does not attach to the medial border of the scapula. *Serratus anterior* - The **serratus anterior** muscle originates from the outer surfaces of the upper 8-9 ribs and inserts along the **entire medial border** of the scapula on its anterior (costal) surface. - It plays a crucial role in protraction and upward rotation of the scapula, keeping it applied to the thoracic wall. *Levator scapulae* - The **levator scapulae** muscle originates from the transverse processes of the C1-C4 vertebrae and inserts into the **superior angle and upper part of the medial border** of the scapula. - Its primary actions are to elevate the scapula and assist in downward rotation. *Rhomboid major* - The **rhomboid major** muscle originates from the spinous processes of T2-T5 vertebrae and attaches to the **medial border** of the scapula between the spine and inferior angle. - It acts to retract, elevate, and rotate the scapula downward.

Q: A nerve injured during axillary lymph node dissection leads to loss of sensation in the medial side of the arm. Which nerve is injured?

Intercostobrachial nerve. ***Intercostobrachial nerve*** - The **intercostobrachial nerve** (T2) is the nerve most commonly injured during **axillary lymph node dissection** - It provides **sensory innervation to the medial side of the upper arm**, specifically the skin over the medial and posterior aspects of the arm [1] - This nerve arises from the **lateral cutaneous branch of the second intercostal nerve** and crosses the axilla to reach the arm [1] - Injury during axillary surgery results in **numbness or paresthesia** in the medial upper arm region, which is a well-recognized complication of breast cancer surgery with axillary node dissection [1] - Studies show **30-80% of patients** undergoing axillary dissection experience intercostobrachial nerve injury *Long thoracic nerve* - The **long thoracic nerve** (C5-C7) innervates the **serratus anterior muscle**, which is crucial for scapular protraction and rotation - Damage to this nerve causes **"winged scapula"**, where the scapula protrudes posteriorly - This is a **motor nerve**, not sensory, so injury does not result in sensory deficits in the arm *Medial pectoral nerve* - The **medial pectoral nerve** (C8-T1) primarily innervates the **pectoralis major** and **pectoralis minor** muscles [1] - This is a **motor nerve** playing a role in muscle function rather than sensation [1] - Injury would result in weakness of these muscles, not sensory loss *Accessory nerve* - The **accessory nerve** (cranial nerve XI) innervates the **sternocleidomastoid** and **trapezius muscles** - This nerve is located in the **posterior triangle of the neck**, not in the axilla - Injury would lead to weakness in shrugging the shoulders or turning the head, not sensory loss in the arm during axillary dissection

Q: Which of the following statements about the limbus fossa ovalis is false?

Derived from septum primum. ***Derived from septum primum*** - The **limbus fossa ovalis** (or annulus ovalis) is a structure in the right atrium that forms the prominent rim of the **fossa ovalis**. - It is derived from the inferior border of the **septum secundum**, not the septum primum, which primarily forms the floor of the fossa ovalis. *Forms the rim around fossa ovalis* - The **limbus fossa ovalis** is indeed the thickened, crescent-shaped border of tissue that surrounds the **fossa ovalis** in the interatrial septum. - This anatomical arrangement is a remnant of the **foramen ovale** from fetal circulation [1]. *In right atrium* - The **fossa ovalis** and its surrounding limbus are located on the septal wall of the **right atrium** [1]. - This position is crucial for its role as a key landmark in interatrial septum anatomy. *Also called Annulus ovalis* - The term **annulus ovalis** is a widely accepted synonym for the **limbus fossa ovalis**. - Both terms describe the same anatomical structure, the fibrous rim surrounding the fossa ovalis.

Q: Which is the first bone to start ossifying?

Clavicle. ***Clavicle*** - The **clavicle** is the **first bone to begin ossification** in the human body, starting around the **5th-6th week of gestation**. - It ossifies via **intramembranous ossification**, making it unique among long bones [1]. - This early ossification is a key landmark in fetal skeletal development and is consistently taught across medical curricula. *Mandible* - The **mandible** begins ossification around the **6th week of gestation**, shortly after the clavicle [1]. - While it is one of the earliest bones to ossify, it is **not the first**. - It also undergoes intramembranous ossification [1]. *Femur* - The **femur**, a long bone, begins ossification around the **7th-8th week of gestation** [1]. - It ossifies via **endochondral ossification**, which typically occurs later than intramembranous ossification [1]. *Tibia* - The **tibia** also begins ossification around the **7th-8th week of gestation**. - Like the femur, it follows the endochondral ossification pathway.

Q: Uvula vesicae seen in bladder is formed from the following structure?

Median lobe of the prostate. ***Median lobe of the prostate*** - The **uvula vesicae** is a slight median elevation on the internal surface of the **bladder base**, immediately behind the **internal urethral orifice**. - This elevation is formed by the underlying **median (middle) lobe of the prostate** projecting upward beneath the bladder mucosa. - In **benign prostatic hyperplasia (BPH)**, enlargement of the median lobe accentuates this prominence and can cause significant urinary obstruction. *Lateral lobe of the prostate* - Enlargement of the **lateral lobes** causes lateral compression of the prostatic urethra, not a median elevation at the bladder neck. - While they are the most common site of **BPH**, they do not form the uvula vesicae. *Anterior lobe of the prostate* - The **anterior lobe** (or anterior fibromuscular stroma) is located in front of the urethra and is non-glandular. - It does not contribute to the formation of the uvula vesicae or cause significant urinary symptoms. *Posterior lobe of the prostate* - The **posterior lobe** is located behind the urethra and is the most common site for **prostate cancer**. - It does not project into the bladder base and therefore does not form the uvula vesicae.

Q: Root value of the thoracodorsal nerve

C6, C7, C8. ***C6, C7, C8*** - The **thoracodorsal nerve**, also known as the middle subscapular nerve, originates from the **posterior cord of the brachial plexus**. - Its specific root values are **C6, C7, and C8**, which supply motor innervation to the **latissimus dorsi muscle** [1]. - This nerve is one of the three subscapular nerves arising from the posterior cord [1]. *C5, C6, C7* - While these roots contribute to the **posterior cord**, the thoracodorsal nerve specifically arises from **C6, C7, C8**. - **C5** primarily contributes to the **upper and middle trunk** and is more associated with nerves like the **suprascapular** and **axillary nerves**. *C6, T1* - These root values contribute to various nerves of the **brachial plexus**, but not specifically the thoracodorsal nerve. - **T1** contributes mainly to the **medial cord** and its branches like the **ulnar nerve**, not the posterior cord from which the thoracodorsal nerve arises. *T1, T2* - These are typical root values for **intercostal nerves** and contribute to the **sympathetic trunk**, not the **brachial plexus** or its branches like the thoracodorsal nerve. - The brachial plexus predominantly arises from **C5 to T1 spinal nerve roots**, and **T2** is not part of the brachial plexus.

Q: The uterine artery is a branch of which of the following?

Internal iliac artery. ***Internal iliac artery*** - The **uterine artery** is a direct branch of the **internal iliac artery**, specifically its anterior division, which supplies blood to the uterus [1]. - This artery is crucial for maintaining the vascular supply to the uterus, especially during pregnancy. *Left common iliac artery* - The **common iliac artery** bifurcates into the **internal iliac artery** and the **external iliac artery** [2]; it is not a direct source of the uterine artery. - The common iliac artery is a more proximal vessel in the arterial tree. *Internal pudendal artery* - The **internal pudendal artery** is also a branch of the **internal iliac artery**, but it primarily supplies the perineum and external genitalia, not the uterus. - It is often associated with structures such as the clitoris, labia, and structures of the anal triangle. *Ovarian artery* - The **ovarian artery** originates directly from the **abdominal aorta**, usually just below the renal arteries, and supplies the ovaries [2]. - Although it supplies the reproductive system, it is distinct from the uterine artery's origin and primary territory.

Q: Which of the following is not formed by the external oblique muscle?

Conjoint tendon. ***Conjoint tendon*** - The **conjoint tendon** is formed by the conjoined aponeuroses of the **internal oblique** and **transversus abdominis muscles**, not the external oblique [1]. - It provides posterior wall reinforcement to the inguinal canal. - This is the structure that is definitively **NOT formed by the external oblique muscle**. *Lacunar ligament* - The **lacunar ligament** (Gimbernat's ligament) is a triangular fascial band formed by the medial reflection of the **inguinal ligament**. - It is derived from the **external oblique aponeurosis** and forms the medial boundary of the femoral ring. *Pectineal ligament* - The **pectineal ligament** (Cooper's ligament) is a thickening of the periosteum along the pecten pubis (pectineal line) [3]. - While it is continuous with the lacunar ligament, it is not directly formed by the external oblique muscle itself, but rather represents a separate periosteal structure. - For the purposes of this question, the conjoint tendon is the most appropriate answer as it has no contribution from the external oblique. *Inguinal ligament* - The **inguinal ligament** (Poupart's ligament) is formed by the inferomedial border of the **external oblique aponeurosis**, folding back on itself [2]. - It spans between the **anterior superior iliac spine** and the **pubic tubercle**.

Q: The delusion that involves the belief that a familiar person has been replaced by someone else is known as?

Capgras syndrome. ***Capgras syndrome*** - This **delusional misidentification syndrome** is characterized by the belief that a familiar person (e.g., a spouse, child, or parent) has been replaced by an identical imposter. - It often occurs in individuals with **schizophrenia**, **dementia**, or following **brain injury**. *Cotard syndrome* - This syndrome involves a nihilistic delusion where the individual believes they are **dead**, do not exist, or have lost their organs or blood. - It is often associated with severe **depression**, psychosis, or neurological disorders. *Othello syndrome* - Also known as **delusional jealousy**, this involves the unfounded belief that one's partner is being unfaithful. - It is a **primary delusional disorder** but can also be seen in conditions like alcohol dependence or neurodegenerative diseases. *Fregoli syndrome* - This is another **delusional misidentification syndrome** where the person believes that different people are actually the same person in disguise. - It is the opposite of Capgras syndrome and may occur in **schizophrenia** or **organic brain disorders**.

Question 1

Which muscle of the arm has additional supinator action?

Accepted Answer

Biceps

Answer

Brachialis

Answer

Coracobrachialis

Answer

Triceps

Question 2

Which of the following muscles is not attached to the medial border of the scapula?

Accepted Answer

Teres major

Answer

Serratus anterior

Answer

Levator scapulae

Answer

Rhomboid major

Question 3

A nerve injured during axillary lymph node dissection leads to loss of sensation in the medial side of the arm. Which nerve is injured?

Accepted Answer

Intercostobrachial nerve

Answer

Long thoracic nerve

Answer

Medial pectoral nerve

Answer

Accessory nerve

Question 4

Which of the following statements about the limbus fossa ovalis is false?

Accepted Answer

Derived from septum primum

Answer

Also called Annulus ovalis

Answer

In right atrium

Answer

Forms the rim around fossa ovalis

Question 5

Which is the first bone to start ossifying?

Accepted Answer

Clavicle

Answer

Femur

Answer

Tibia

Answer

Mandible

Question 6

Uvula vesicae seen in bladder is formed from the following structure?

Accepted Answer

Median lobe of the prostate

Answer

Lateral lobe of the prostate

Answer

Anterior lobe of the prostate

Answer

Posterior lobe of the prostate

Question 7

Root value of the thoracodorsal nerve

Accepted Answer

C6, C7, C8

Answer

T1, T2

Answer

C5, C6, C7

Answer

C6, T1

Question 8

The uterine artery is a branch of which of the following?

Accepted Answer

Internal iliac artery

Answer

Left common iliac artery

Answer

Internal pudendal artery

Answer

Ovarian artery

Question 9

Which of the following is not formed by the external oblique muscle?

Accepted Answer

Conjoint tendon

Answer

Inguinal ligament

Answer

Lacunar ligament

Answer

Pectineal ligament

Question 10

The delusion that involves the belief that a familiar person has been replaced by someone else is known as?

Accepted Answer

Capgras syndrome

Answer

Cotard syndrome

Answer

Othello syndrome

Answer

Fregoli syndrome

NEET-PG 2015

Anatomy

Psychiatry